Redesigning rotation schedules

Residency Program Insider, February 26, 2016

One of the biggest scheduling struggles facing program directors is the service versus education issue. The ACGME Common Program Requirements make it clear that service responsibilities must not compromise the learning program. Program leadership must carve out time for educational activities and still provide residents with appropriate patient care encounters.

A common solution for the service versus education issue is to redesign the training program to provide more protected educational time. To do this, program directors may have to evaluate rotation schedules and which attending physicians receive resident support. Coordinators can pull reports from the ACGME Case Log System, compile information on evaluations, analyze the data, and provide program directors with information they will consider when redesigning the program.

Coordinators should examine the following information when considering how to redesign the program:
• Rotations: Review the existing rotations for the ones that expose residents to the same disease processes or the same procedural experiences. Check the Case Log System to see the accumulation and type of experiences in each duplicated rotations. Consider where the best experience is and eliminate the other rotation.
• Evaluations: Review the evaluations residents complete for duplicate rotations and determine which one teaches the subject matter most effectively. Consider eliminating the other rotation.
• ACGME Case Log System: Monitor how much time it takes residents to meet patient encounter requirements on a particular rotation. If residents consistently acquire the patient cases required long before the rotation finishes, consider adding more education time to that rotation, or reduce the time residents spend on that rotation and create a new rotation. Coordinators should look at reports in the Case Log System to monitor patient contact or case procedure numbers that residents acquire at the facilities they rotate through. Determine whether residents are getting the patients/cases they need. If the amount of patient contacts is decreasing, consider moving the residents to another facility that will increase the resident educational experience
Source: The Residency Coordinator’s Handbook, Third Edition

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